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u
p
s
.
T
h
is
p
an
d
e
m
ic
af
f
ec
t
s
t
h
e
p
s
y
c
h
o
lo
g
ical
asp
ec
ts
o
f
co
lle
g
e
s
tu
d
e
n
ts
[
1
2
]
,
teac
h
er
s
an
d
s
tu
d
e
n
ts
[
1
3
]
,
p
r
esen
ts
a
m
aj
o
r
m
en
ta
l
h
ea
lt
h
c
h
alle
n
g
e
to
o
ld
er
ad
u
lts
[
1
4
]
,
y
o
u
n
g
ad
u
lt
[
1
5
]
,
an
d
in
ter
n
al
m
i
g
r
an
t
w
o
r
k
er
[
1
6
]
.
C
OVI
D
-
1
9
also
h
as a
s
ig
n
i
f
ica
n
t i
m
p
a
ct
o
n
th
e
an
x
iet
y
o
f
m
ed
ical
p
er
s
o
n
n
el
[
1
7
-
1
9
]
.
A
s
t
u
d
y
r
e
v
ea
led
th
at
n
u
r
s
e
s
w
h
o
co
-
tr
ea
t
C
O
VI
D
-
1
9
p
atien
ts
s
h
o
w
ed
s
ti
m
u
latio
n
/
s
en
s
iti
v
it
y
,
ir
r
itab
ilit
y
,
r
el
u
ctan
ce
to
r
est,
an
d
s
i
g
n
s
o
f
p
s
y
c
h
o
lo
g
ical
d
i
s
o
r
d
er
s
,
b
u
t
r
ef
u
s
e
p
s
y
c
h
o
lo
g
i
ca
l
h
elp
a
n
d
clai
m
th
at
th
e
y
d
o
n
o
t
h
av
e
an
y
p
r
o
b
lem
s
[
2
0
]
.
Me
d
ical
p
er
s
o
n
n
el
ar
e
a
ls
o
co
n
ce
r
n
ed
ab
o
u
t
a
lac
k
o
f
p
er
s
o
n
al
p
r
o
tectiv
e
eq
u
ip
m
en
t,
as
w
ell
as
a
f
ee
lin
g
o
f
b
ein
g
u
n
ab
le
to
tr
ea
t
cr
itical
p
atien
ts
[
2
0
]
.
T
h
e
y
f
ac
e
a
h
ig
h
lev
e
l
of
s
tr
ess
,
in
c
lu
d
i
n
g
a
h
i
g
h
r
is
k
o
f
co
n
tr
ac
tin
g
,
o
v
er
w
o
r
k
,
f
r
u
s
tr
atio
n
,
d
is
cr
i
m
i
n
atio
n
,
is
o
latio
n
,
d
ea
lin
g
w
it
h
p
atien
ts
w
i
th
n
eg
at
iv
e
e
m
o
tio
n
s
,
i
n
ten
s
e
f
a
m
il
y
r
elatio
n
s
h
ip
s
,
an
d
f
ati
g
u
e
[
2
1
]
.
I
t
is
p
r
ed
ic
ted
th
at
th
i
s
an
x
iet
y
d
is
o
r
d
er
ca
n
in
ter
f
er
e
w
i
th
t
h
e
w
o
r
k
p
er
f
o
r
m
a
n
ce
o
f
h
ea
l
th
w
o
r
k
er
s
,
esp
ec
ial
l
y
w
h
en
d
ea
l
in
g
w
i
th
C
OVI
D
-
19
p
atien
ts
.
Sev
er
al
s
tu
d
ie
s
r
ev
ea
l
th
a
t
t
h
e
a
n
x
ie
t
y
e
x
p
er
ien
ce
d
b
y
w
o
r
k
er
s
h
a
s
a
co
r
r
elatio
n
with
s
ev
er
al
d
i
m
en
s
io
n
s
o
f
w
o
r
k
p
er
f
o
r
m
a
n
ce
[
2
2
-
2
5
]
.
W
o
r
k
p
er
f
o
r
m
a
n
ce
co
n
s
i
s
ts
o
f
e
x
p
licit
j
o
b
b
eh
av
io
r
th
a
t
i
n
clu
d
e
s
th
e
f
u
n
d
a
m
en
tal
j
o
b
r
esp
o
n
s
i
b
ilit
ies
a
s
s
i
g
n
ed
as
p
ar
t
o
f
t
h
e
j
o
b
d
escr
ip
tio
n
[
2
6
]
.
P
er
f
o
r
m
an
ce
s
ta
n
d
ar
d
s
ar
e
s
et
b
ased
o
n
j
o
b
cr
iter
ia
th
at
e
x
p
lain
w
h
at
t
h
e
o
r
g
a
n
izat
io
n
h
as
g
iv
e
n
its
e
m
p
lo
y
ee
s
to
d
o
,
th
er
ef
o
r
e
i
n
d
iv
id
u
al
p
er
f
o
r
m
a
n
ce
in
j
o
b
cr
iter
ia
m
u
s
t
b
e
m
ea
s
u
r
ed
,
co
m
p
ar
ed
w
it
h
e
x
is
t
in
g
s
ta
n
d
ar
d
s
an
d
th
e
r
es
u
lt
s
m
u
s
t
b
e
n
o
tifie
d
to
all
e
m
p
lo
y
ee
s
.
Sev
er
al
asp
ec
ts
o
f
w
o
r
k
p
er
f
o
r
m
a
n
ce
w
er
e
e
x
p
r
ess
ed
b
y
s
ev
er
al
ex
p
er
ts
,
i
n
cl
u
d
in
g
cr
ea
tiv
it
y
,
r
ea
ctiv
it
y
i
n
th
e
f
ac
e
o
f
d
if
f
icu
l
ties
,
i
n
ter
p
er
s
o
n
al
ad
ap
tab
ilit
y
,
tr
ai
n
i
n
g
e
f
f
o
r
ts
,
an
d
h
a
n
d
lin
g
w
o
r
k
-
r
elate
d
s
tr
ess
.
I
n
ad
d
itio
n
,
o
th
er
co
n
ce
p
ts
also
m
e
n
tio
n
asp
ec
ts
o
f
tas
k
p
er
f
o
r
m
an
ce
,
co
n
te
x
tu
a
l
p
er
f
o
r
m
an
ce
,
an
d
co
u
n
ter
-
p
r
o
d
u
cti
v
e
w
o
r
k
b
eh
av
io
r
[
2
7
]
.
T
ask
p
er
f
o
r
m
a
n
ce
is
an
i
n
d
iv
id
u
a
l
'
s
p
r
o
f
icie
n
c
y
in
p
er
f
o
r
m
i
n
g
co
r
e
o
r
tech
n
ical
tas
k
s
i
n
h
is
j
o
b
[
2
8
]
;
c
o
n
tex
t
u
al
p
er
f
o
r
m
a
n
ce
is
b
eh
av
io
r
th
at
s
u
p
p
o
r
ts
th
e
o
r
g
an
izat
io
n
al,
s
o
cial
an
d
p
s
y
c
h
o
lo
g
ical
e
n
v
i
r
o
n
m
e
n
t
in
w
h
ic
h
t
h
e
tech
n
i
ca
l
co
r
e
m
u
s
t
f
u
n
ct
io
n
[
2
9
]
;
o
n
th
e
o
th
er
h
an
d
,
co
u
n
ter
p
r
o
d
u
ctiv
e
w
o
r
k
b
eh
a
v
io
r
is
b
eh
av
io
r
th
at
h
ar
m
s
th
e
w
ell
-
b
ein
g
o
f
t
h
e
o
r
g
an
izat
i
o
n
[
3
0
]
.
T
h
ese
th
r
ee
d
i
m
en
s
io
n
s
th
e
n
f
o
r
m
th
e
b
as
i
s
f
o
r
p
r
ep
ar
in
g
th
e
I
n
d
iv
id
u
a
l W
o
r
k
P
er
f
o
r
m
an
ce
q
u
e
s
tio
n
n
a
ir
e
[
2
7
]
.
C
u
r
r
en
tl
y
,
it
i
s
v
er
y
i
m
p
o
r
tan
t
to
k
n
o
w
in
d
etail
ab
o
u
t
th
e
a
n
x
iet
y
e
x
p
er
ien
ce
d
b
y
m
ed
ical
p
er
s
o
n
n
el,
s
o
th
at
it
ca
n
b
e
u
s
ed
as
a
b
as
is
f
o
r
p
s
y
ch
o
lo
g
ical
in
ter
v
en
ti
o
n
o
n
th
e
m
.
I
n
p
ar
t
icu
lar
,
th
i
s
s
tu
d
y
ai
m
ed
to
:
1
)
ev
alu
a
te
t
h
e
an
x
iet
y
e
x
p
er
ien
ce
d
b
y
m
ed
ical
p
er
s
o
n
n
el
w
h
en
d
ea
lin
g
w
i
th
C
OVI
D
-
1
9
;
2
)
as
a
th
eo
r
etica
l
b
asis
f
o
r
p
r
o
v
id
in
g
p
s
y
ch
o
lo
g
ical
in
ter
v
e
n
tio
n
to
m
ed
ical
p
er
s
o
n
n
el;
3
)
as
m
ater
ial
f
o
r
p
o
lic
y
m
ak
in
g
b
y
t
h
e
g
o
v
er
n
m
e
n
t r
elate
d
to
i
m
p
r
o
v
i
n
g
t
h
e
m
en
ta
l h
ea
lt
h
o
f
m
ed
ic
al
p
er
s
o
n
n
el.
2.
RE
S
E
ARCH
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n a
nd
pa
rt
icipa
nts
A
cr
o
s
s
-
s
ec
tio
n
a
l
s
u
r
v
e
y
u
s
ed
in
th
i
s
s
t
u
d
y
ai
m
ed
to
m
ea
s
u
r
e
an
x
iet
y
a
n
d
in
d
iv
i
d
u
al
w
o
r
k
p
er
f
o
r
m
a
n
ce
o
f
h
ea
lt
h
w
o
r
k
er
s
f
r
o
m
J
u
n
e
17,
2
0
2
0
to
J
u
l
y
2
5
,
2
0
2
0
.
P
ar
ticip
an
ts
in
t
h
is
s
tu
d
y
w
er
e
m
ed
ical
p
er
s
o
n
n
el
i
n
I
n
d
o
n
esia
w
h
o
w
er
e
h
a
n
d
li
n
g
s
u
s
p
ec
ted
an
d
co
n
f
ir
m
ed
C
OVI
D
-
1
9
ca
s
es
,
w
h
ic
h
ar
e
class
i
f
ied
in
to
th
r
ee
g
r
o
u
p
s
,
n
a
m
e
l
y
d
o
cto
r
s
,
n
u
r
s
es,
a
n
d
o
th
er
h
ea
lt
h
w
o
r
k
er
s
(
m
id
w
i
f
er
y
p
er
s
o
n
n
el,
p
h
ar
m
ac
e
u
tica
l
tech
n
ical
p
er
s
o
n
n
el,
b
io
m
ed
ic
al
en
g
i
n
ee
r
in
g
p
er
s
o
n
n
el)
.
A
t
o
tal
o
f
5
0
1
p
ar
ticip
an
ts
p
ar
ticip
ated
in
f
illi
n
g
o
u
t
th
is
q
u
esti
o
n
n
air
e.
T
ab
l
e
1
s
h
o
w
s
th
e
d
e
m
o
g
r
ap
h
ic
a
n
d
o
th
er
s
p
ec
ial
ch
ar
ac
ter
is
tic
s
.
De
m
o
g
r
ap
h
ic
c
h
ar
ac
ter
is
tic
s
an
d
o
th
er
s
p
ec
ial
c
h
ar
ac
ter
is
t
i
cs
ca
n
b
e
s
ee
n
in
T
ab
le
1
.
W
o
m
e
n
w
h
o
p
ar
ticip
ated
in
f
illi
n
g
o
u
t
t
h
is
q
u
esti
o
n
n
air
e
w
er
e
5
7
.
5
%,
w
h
ile
m
en
w
er
e
4
2
.
5
%;
Fu
r
t
h
er
m
o
r
e,
in
t
h
e
ag
e
f
ac
to
r
,
th
e
m
o
s
t
p
ar
ticip
ati
n
g
ag
e
g
r
o
u
p
s
w
er
e
2
1
-
2
5
(
4
5
.
5
%),
f
o
llo
w
ed
b
y
t
h
e
2
6
-
3
5
,
3
6
-
4
5
an
d
4
6
-
5
5
ag
e
g
r
o
u
p
s
,
r
esp
ec
ti
v
el
y
4
1
.
5
%,
1
0
.
8
%
an
d
2
.
2
%;
On
th
e
c
h
ar
ac
ter
is
tic
s
o
f
t
h
e
t
y
p
e
o
f
w
o
r
k
f
o
r
ce
,
n
u
r
s
es
d
o
m
i
n
ate
4
1
.
9
%,
f
o
llo
w
ed
b
y
d
o
cto
r
s
an
d
o
th
er
h
ea
l
th
w
o
r
k
er
s
(
3
7
.
5
%
an
d
2
0
.
6
%);
o
n
t
h
e
c
h
ar
ac
ter
is
tic
s
o
f
th
e
len
g
t
h
o
f
w
o
r
k
,
m
o
r
e
d
o
m
i
n
ated
b
y
h
ea
lt
h
w
o
r
k
er
s
w
h
o
s
e
w
o
r
k
p
er
io
d
w
a
s
<4
y
ea
r
s
(
5
9
.
9
%),
th
en
s
eq
u
e
n
tiall
y
4
-
8
y
ea
r
s
,
9
-
1
3
y
ea
r
s
,
1
4
-
1
8
y
ea
r
s
,
1
9
-
2
3
y
ea
r
s
an
d
>
2
3
y
ea
r
s
,
n
a
m
e
l
y
2
2
.
3
%,
1
0
.
0
%,
5
.
2
%,
1
.
4
%
an
d
1
.
2
%;
last
l
y
,
5
1
.
9
0
%
o
f
p
ar
ticip
a
n
ts
w
o
r
k
ed
at
r
ef
er
r
al
h
o
s
p
ital
s
f
o
r
C
OVI
D
-
1
9
p
atien
t
s
,
w
h
ile
4
8
.
1
0
%
o
f
p
ar
ticip
an
ts
w
o
r
k
e
d
f
o
r
h
o
s
p
itals
o
r
clin
ics t
h
at
w
er
e
n
o
t a
r
ef
er
r
al
f
o
r
C
OVI
D
-
1
9
p
atien
ts
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t.
J
.
P
u
b
lic
Hea
lth
Sci.
I
SS
N:
2
2
5
2
-
8806
Gen
era
liz
ed
a
n
xiety
d
is
o
r
d
er a
s
s
o
cia
ted
w
ith
in
d
ivid
u
a
l wo
r
k
p
erfo
r
ma
n
ce
…
(
E
ko
S
u
ja
d
i
)
209
T
ab
le
1
.
Dem
o
g
r
ap
h
ic
c
h
ar
ac
t
er
is
tics
a
n
d
s
p
ec
if
ic
c
h
ar
ac
ter
is
tics
o
f
p
ar
ticip
an
ts
2
.
2
.
I
ns
t
ru
m
e
nts
2
.
2
.
1
.
G
ener
a
lized
a
nx
iet
y
di
s
o
rder
s
ca
le
(
G
AD
-
7)
T
h
e
Gen
er
alize
d
An
x
iet
y
D
is
o
r
d
er
Scale
(
GA
D
-
7
)
u
s
ed
in
th
is
s
t
u
d
y
ai
m
ed
to
m
ea
s
u
r
e
t
h
e
an
x
iet
y
ex
p
er
ien
ce
d
b
y
p
ar
ticip
an
ts
.
T
h
is
in
s
tr
u
m
e
n
t
m
ea
s
u
r
es
t
h
e
an
x
iet
y
s
y
m
p
to
m
s
ex
p
er
ien
c
ed
b
y
p
ar
ticip
a
n
t
s
r
elate
d
to
C
OVI
D
-
1
9
in
t
h
e
p
as
t
t
w
o
w
ee
k
s
.
G
A
D
-
7
co
n
s
is
ts
o
f
s
e
v
en
ite
m
s
u
s
i
n
g
f
o
u
r
L
ik
er
t
s
ca
le
o
p
tio
n
s
,
n
a
m
e
l
y
0
=
n
o
t a
t
all,
1
=
s
ev
er
al
d
a
y
s
,
2
=
m
o
r
e
t
h
an
h
al
f
th
e
d
ay
s
,
a
n
d
3
=
n
ea
r
l
y
e
v
er
y
d
a
y
.
GAD
-
7
n
o
r
m
s
ar
e
in
ter
p
r
eted
as:
m
i
n
i
m
al
(
0
-
4
)
,
m
ild
(
5
-
9
)
,
m
o
d
er
ate
(
1
0
-
1
4
)
an
d
s
ev
er
e
(
1
4
-
2
0
)
.
T
h
is
s
ca
l
e
is
r
ep
o
r
ted
to
b
e
r
eliab
le
an
d
v
alid
f
o
r
m
ea
s
u
r
i
n
g
a
n
x
iet
y
in
b
o
th
g
e
n
er
al
an
d
s
p
ec
ial
g
r
o
u
p
s
[
3
1
,
3
2
]
.
W
e
u
s
e
t
h
is
s
ca
le
i
n
th
e
I
n
d
o
n
esia
n
v
er
s
io
n
.
I
n
ter
n
al
v
alid
it
y
a
n
d
r
eliab
ilit
y
f
o
r
I
n
d
o
n
esia
n
v
er
s
io
n
o
f
G
A
D
-
7
w
er
e
s
atis
f
ac
to
r
y
w
i
t
h
v
alid
it
y
co
e
f
f
icie
n
t o
f
0
.
6
4
8
to
0
.
8
0
0
(
p
<
0
.
0
1
)
an
d
C
r
o
n
b
ac
h
’
s
a
lp
h
a
v
al
u
e
o
f
0
.
8
6
7
[
3
2
]
.
2
.
2
.
2
.
I
nd
iv
i
d
ua
l
w
o
rk
perf
o
r
m
a
nc
e
qu
estio
nn
a
ire
I
n
t
h
is
s
t
u
d
y
,
W
o
r
k
p
er
f
o
r
m
an
ce
w
as
m
ea
s
u
r
ed
u
s
in
g
t
h
e
I
n
d
iv
id
u
al
W
o
r
k
P
e
r
f
o
r
m
an
c
e
Qu
est
io
n
n
air
e
(
I
W
P
-
1
.
0
)
[
3
3
]
.
T
h
is
q
u
esti
o
n
n
air
e
co
n
s
is
t
s
o
f
1
8
ite
m
s
.
A
ll
ite
m
s
h
ad
a
r
ec
all
p
er
io
d
o
f
3
m
o
n
t
h
s
.
T
h
is
s
ca
le
co
n
s
is
t
s
o
f
3
d
im
en
s
io
n
s
,
n
a
m
el
y
ta
s
k
p
e
r
f
o
r
m
an
ce
(
T
P
)
co
n
s
is
ti
n
g
o
f
5
item
s
,
co
n
tex
tu
al
p
er
f
o
r
m
a
n
ce
(
C
P
)
co
n
s
is
t
in
g
o
f
8
ite
m
s
a
n
d
co
u
n
ter
p
r
o
d
u
ctiv
e
w
o
r
k
b
eh
a
v
io
r
(
C
W
B
)
co
n
s
is
tin
g
o
f
ei
g
h
t
ite
m
s
[
3
3
]
.
T
h
is
q
u
es
tio
n
n
air
e
u
s
es
a
f
iv
e
-
c
h
o
ice
L
i
k
er
t
s
ca
le
(
T
P
an
d
C
P
:
s
e
ld
o
m
,
s
o
m
eti
m
es,
r
eg
u
lar
l
y
,
o
f
ten
,
al
w
a
y
s
;
C
W
B
: n
e
v
er
,
s
e
ld
o
m
,
s
o
m
et
i
m
e
s
,
r
eg
u
lar
l
y
,
o
f
te
n
)
.
T
h
is
q
u
e
s
tio
n
n
air
e
h
as a
h
i
g
h
co
ef
f
icie
n
t o
f
r
eliab
ilit
y
a
n
d
v
alid
it
y
;
t
h
e
r
eli
ab
ilit
y
co
ef
f
icie
n
t
f
o
r
task
p
er
f
o
r
m
a
n
ce
is
0
.
7
8
,
co
n
tex
t
u
al
p
e
r
f
o
r
m
an
ce
i
s
0
.
8
5
,
an
d
co
u
n
ter
-
p
r
o
d
u
ctiv
e
w
o
r
k
b
eh
av
io
r
is
0
.
7
9
[
3
4
]
.
2
.
3
.
Sta
t
is
t
ica
l
an
a
ly
s
is
A
ll
d
ata
w
er
e
a
n
al
y
ze
d
u
s
i
n
g
I
B
M
SP
SS
v
er
s
io
n
2
4
.
Descr
i
p
tiv
e
s
tati
s
tic
s
(
f
r
eq
u
e
n
c
y
,
p
er
ce
n
tag
e
s
,
m
ea
n
,
a
n
d
s
ta
n
d
ar
d
d
ev
iatio
n
)
w
er
e
u
s
ed
to
d
escr
ib
e
g
e
n
e
r
al
h
ea
lt
h
w
o
r
k
er
an
x
iet
y
a
s
w
e
ll
as
b
ased
o
n
d
em
o
g
r
ap
h
ic
a
n
d
o
th
er
s
p
ec
ial
ch
ar
ac
ter
is
tic
s
.
Mu
lti
v
ar
iat
e
an
al
y
s
is
o
f
h
ea
lt
h
w
o
r
k
er
an
x
ie
t
y
i
n
ter
m
s
o
f
g
en
d
er
u
s
in
g
t
h
e
Ma
n
-
W
h
i
tn
e
y
test
,
w
h
i
le
Kr
u
s
k
a
l
-
W
alli
s
a
r
e
u
s
ed
to
r
ev
ea
l
d
if
f
er
e
n
ce
s
i
n
an
x
iet
y
in
ter
m
s
o
f
o
th
er
c
h
ar
ac
ter
is
t
ics.
Fu
r
th
er
m
o
r
e,
Sp
ea
r
m
an
's
R
an
k
-
Or
d
er
C
o
r
r
elatio
n
is
u
s
ed
to
d
eter
m
in
e
t
h
e
r
elatio
n
s
h
ip
b
et
w
ee
n
g
e
n
er
ali
ze
d
an
x
iet
y
d
is
o
r
d
er
an
d
in
d
iv
id
u
al
d
i
m
e
n
s
io
n
s
o
f
w
o
r
k
p
er
f
o
r
m
a
n
ce
(
tas
k
p
er
f
o
r
m
a
n
ce
,
co
n
te
x
t
u
al
p
er
f
o
r
m
an
ce
,
a
n
d
co
u
n
ter
p
r
o
d
u
ctiv
e
w
o
r
k
b
eh
a
v
io
r
)
.
3.
RE
SU
L
T
S
A
ND
D
I
SCU
SS
I
O
N
3
.
1
.
Resul
t
s
T
ab
le
2
s
h
o
w
s
t
h
at
3
3
.
3
3
%
o
f
p
ar
ticip
an
ts
d
id
n
o
t
ex
p
er
ien
ce
an
x
iet
y
d
i
s
o
r
d
er
s
(
m
i
n
i
m
al)
,
th
e
n
3
1
.
1
4
%
o
f
p
ar
ticip
an
ts
ex
p
er
ien
ce
d
m
o
d
er
ate
lev
els
o
f
an
x
i
et
y
d
is
o
r
d
er
,
f
o
llo
w
ed
b
y
m
i
l
d
an
d
s
ev
er
e
lev
els
o
f
2
7
.
7
4
%
an
d
7
.
7
8
%.
Fu
r
th
er
m
o
r
e,
T
ab
le
3
ex
p
lain
s
th
e
d
if
f
er
en
ce
s
in
a
n
x
ie
t
y
i
n
ter
m
s
o
f
g
e
n
d
er
,
ag
e,
t
y
p
e
o
f
m
ed
ical
p
er
s
o
n
n
el,
a
n
d
len
g
t
h
o
f
w
o
r
k
ex
p
er
ie
n
ce
.
T
h
e
r
esu
lt
s
o
f
t
h
e
an
al
y
s
is
s
h
o
w
t
h
at:
1
)
th
er
e
i
s
a
d
if
f
er
e
n
ce
i
n
a
n
x
iet
y
i
n
ter
m
s
o
f
g
e
n
d
er
(
p
<.
0
0
0
)
,
w
h
er
e
t
h
e
av
er
ag
e
s
co
r
e
o
f
w
o
m
e
n
's
a
n
x
iet
y
i
s
h
ig
h
er
t
h
a
n
th
at
o
f
m
en
w
it
h
an
a
v
er
ag
e
s
co
r
e
o
f
8
.
4
3
an
d
6
.
4
7
.
2
)
t
h
er
e
is
a
d
if
f
er
e
n
c
e
in
an
x
iet
y
i
n
ter
m
s
o
f
ag
e
(p
<
0
.
0
0
9
)
.
T
a
b
le
2
s
h
o
w
s
t
h
at
t
h
e
h
i
g
h
e
s
t
le
v
el
o
f
an
x
iet
y
was
ex
p
er
ien
ce
d
b
y
m
ed
ical
p
er
s
o
n
n
e
l
ag
ed
2
1
-
2
5
w
it
h
a
n
av
er
ag
e
s
co
r
e
o
f
8
.
4
0
,
w
h
ile
t
h
e
lo
w
e
s
t
lev
e
l
o
f
an
x
iet
y
w
as
e
x
p
er
ien
ce
d
b
y
th
e
4
6
-
4
5
ag
e
g
r
o
u
p
.
3
)
V
a
r
i
a
b
l
e
C
a
t
e
g
o
r
y
F
r
e
q
u
e
n
c
y
P
e
r
c
e
n
t
a
g
e
G
e
n
d
e
r
M
a
l
e
2
1
3
4
2
.
5
1
F
e
mal
e
2
8
8
5
7
.
4
8
A
g
e
21
-
25
2
2
8
4
5
.
5
1
26
-
35
2
0
8
4
1
.
5
2
36
-
45
54
1
0
.
7
9
46
-
55
11
2
.
1
9
Ty
p
e
s o
f
me
d
i
c
a
l
p
e
r
so
n
n
e
l
D
o
c
t
o
r
1
8
8
3
7
.
5
2
N
u
r
se
2
1
0
4
1
.
9
2
O
t
h
e
r
me
d
i
c
a
l
p
e
r
so
n
n
e
l
1
0
3
2
0
.
5
6
l
e
n
g
t
h
o
f
w
o
r
k
i
n
g
e
x
p
e
r
i
e
n
c
e
L
e
ss t
h
a
n
4
Y
e
a
r
s
3
0
0
5
9
.
8
8
4
-
8
Y
e
a
r
s
1
1
2
2
2
.
3
6
9
-
1
3
Y
e
a
r
s
50
9
.
9
8
14
-
1
8
Y
e
a
r
s
26
5
.
1
9
19
-
2
3
Y
e
a
r
s
7
1
.
4
0
M
o
r
e
t
h
a
n
2
3
Y
e
a
r
s
6
1
.
2
0
H
o
sp
i
t
a
l
t
y
p
e
A
r
e
f
e
r
r
a
l
f
o
r
C
O
V
I
D
-
19
p
a
t
i
e
n
t
s
2
6
0
5
1
.
9
0
N
o
t
a
r
e
f
e
r
r
a
l
f
o
r
C
O
V
I
D
-
19
p
a
t
i
e
n
t
s
2
4
1
4
8
.
1
0
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N:
2
2
5
2
-
8
8
0
6
I
n
t.
J
.
P
u
b
lic
Hea
lth
Sci.
Vo
l.
1
0
,
No
.
1
,
Ma
r
ch
20
21
:
2
07
–
2
14
210
th
er
e
ar
e
d
if
f
er
en
ce
s
i
n
a
n
x
ie
t
y
b
et
w
ee
n
d
o
cto
r
s
,
n
u
r
s
e
s
a
n
d
o
th
er
m
ed
ic
al
p
er
s
o
n
n
el
(
p
<
0
.
0
1
7
)
;
T
h
e
h
ig
h
est
lev
el
o
f
a
n
x
iet
y
w
as
e
x
p
er
ien
ce
d
b
y
n
u
r
s
e
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o
r
e
th
a
n
5
0
%
o
f
p
ar
ticip
an
ts
ex
p
er
ien
ce
d
an
x
iet
y
a
n
d
p
s
y
ch
o
lo
g
ical
d
is
tr
ess
d
u
r
in
g
th
i
s
p
an
d
e
m
ic
[
3
6
]
.
O
n
e
o
f
th
e
ca
u
s
e
s
o
f
p
u
b
lic
a
n
x
iet
y
r
eg
ar
d
i
n
g
C
O
VI
D
-
1
9
i
s
d
u
e
to
t
h
e
al
m
o
s
t
co
n
s
ta
n
t
f
lo
w
o
f
n
e
w
s
ab
o
u
t
C
O
VI
D
-
1
9
.
T
h
er
ef
o
r
e,
W
HO
r
ec
o
m
m
e
n
d
s
av
o
id
in
g
n
e
w
s
ab
o
u
t
C
OVI
D
-
1
9
th
at
m
a
k
es
y
o
u
u
n
co
m
f
o
r
tab
le,
esp
ec
iall
y
h
o
a
x
n
e
w
s
ab
o
u
t CO
VI
D
-
1
9
[
3
7
]
.
T
h
e
r
esu
lts
o
f
th
i
s
s
tu
d
y
in
d
ic
ated
th
at
3
1
.
1
4
%
o
f
m
ed
ical
p
er
s
o
n
n
el
e
x
p
er
ien
ce
d
a
m
o
d
er
at
e
lev
el
o
f
an
x
ie
t
y
,
f
o
llo
w
ed
b
y
m
ild
a
n
d
s
ev
er
e
lev
el
s
,
n
a
m
el
y
2
7
.
7
4
%
an
d
7
.
7
8
%;
r
ele
v
an
t
to
t
h
e
f
i
n
d
in
g
s
o
f
p
r
ev
io
u
s
s
tu
d
ie
s
w
h
ic
h
r
e
v
ea
led
t
h
at
m
ed
ical
p
er
s
o
n
n
el
e
x
p
er
ien
ce
a
n
x
ie
t
y
d
u
r
i
n
g
t
h
is
p
an
d
e
m
ic
[
1
7
-
1
9
]
.
T
h
e
an
x
iet
y
ex
p
er
ien
ce
d
d
u
r
in
g
th
e
C
O
VI
D
-
19
o
u
tb
r
ea
k
b
y
m
ed
ical
p
er
s
o
n
n
e
l
h
as
b
ee
n
m
ix
ed
.
I
n
co
m
p
ar
i
s
o
n
,
a
s
tu
d
y
o
f
h
ea
lt
h
w
o
r
k
er
s
in
P
er
u
s
h
o
w
e
d
g
r
ea
ter
an
x
iet
y
,
w
it
h
2
1
.
7
%
o
f
m
ed
ical
p
er
s
o
n
n
el
e
x
p
er
ien
ce
d
s
e
v
er
e
an
x
iet
y
d
u
r
in
g
th
i
s
o
u
tb
r
ea
k
.
[
1
8
]
.
Ho
w
e
v
er
,
th
er
e
ar
e
s
tu
d
ies
w
h
ic
h
r
ev
ea
l
th
a
t
o
n
l
y
a
s
m
all
p
r
o
p
o
r
tio
n
o
f
m
ed
ical
p
er
s
o
n
n
el
e
x
p
er
ien
ce
e
x
tr
e
m
el
y
s
ev
er
e
a
n
x
iet
y
[
1
9
]
.
P
ar
t
icip
an
ts
w
h
o
e
x
p
er
ien
ce
d
m
o
d
er
ate
an
d
s
ev
er
e
lev
els
o
f
a
n
x
iet
y
g
e
n
er
all
y
w
o
r
k
ed
at
r
ef
er
r
al
h
o
s
p
ita
ls
f
o
r
C
OVI
D
-
1
9
p
atien
ts
i
n
I
n
d
o
n
e
s
ia,
w
h
ile
p
ar
ticip
an
ts
w
h
o
w
er
e
at
a
m
i
ld
lev
el
w
er
e
th
o
s
e
w
h
o
w
o
r
k
ed
in
h
o
s
p
ital
s
,
h
ea
lt
h
ce
n
ter
s
,
an
d
h
ea
lt
h
cli
n
ics
w
h
o
d
id
n
o
t
d
ir
ec
tly
h
a
n
d
le
C
OVI
D
-
1
9
p
atien
ts
,
b
u
t
s
til
l
h
as
t
h
e
p
o
ten
tial
to
b
ec
o
m
e
t
h
e
f
ir
s
t
h
ea
lt
h
ce
n
ter
v
is
i
ted
b
y
p
atie
n
ts
w
it
h
s
y
m
p
to
m
s
o
f
C
OVI
D
-
1
9
.
T
h
is
f
i
n
d
in
g
s
m
a
y
i
n
d
ee
d
b
e
r
elev
an
t
t
o
p
r
ev
io
u
s
s
tu
d
ie
s
th
at
f
o
u
n
d
th
at
m
ed
ical
p
er
s
o
n
n
el
e
m
p
lo
y
ed
i
n
t
h
e
o
u
tp
atien
t
p
an
d
e
m
ic
cli
n
ic
+
p
a
n
d
e
m
ic
d
ep
ar
t
m
e
n
t
ex
p
er
ien
ce
g
r
ea
ter
a
n
x
ie
t
y
t
h
an
m
ed
ical
p
er
s
o
n
n
el
e
m
p
l
o
y
ed
o
n
l
y
i
n
t
h
e
o
u
tp
atien
t
p
an
d
e
m
i
c
cl
in
ic
o
r
d
ep
ar
tm
e
n
t
[
3
8
]
.
T
h
e
an
x
iet
y
ex
p
er
ie
n
ce
d
b
y
m
ed
ical
p
er
s
o
n
n
el
is
b
ec
au
s
e
th
e
y
h
a
v
e
t
h
e
p
o
ten
tial
t
o
co
n
tr
ac
t
C
OVI
D
-
1
9
f
r
o
m
p
atien
ts
.
E
v
en
s
o
m
e
ca
s
es
o
f
d
ea
th
d
u
e
t
o
C
OVI
D
-
1
9
h
a
v
e
co
m
e
f
r
o
m
m
ed
ical
p
er
s
o
n
n
el
.
As o
f
J
u
l
y
2
0
,
2
0
2
0
,
8
2
1
h
ea
lth
w
o
r
k
er
s
in
Am
er
ica
h
av
e
d
ied
f
r
o
m
C
OVI
D
-
1
9
[
3
9
]
; T
h
e
I
n
d
o
n
esia
n
Do
cto
r
s
Ass
o
ciatio
n
also
r
ep
o
r
ted
th
a
t
6
8
d
o
cto
r
s
d
ied
[
4
0
]
,
th
is
d
o
es
n
o
t
i
n
cl
u
d
e
o
th
er
m
ed
ica
l
p
er
s
o
n
n
e
l.
Ma
n
y
s
ac
r
if
ice
s
h
a
v
e
b
ee
n
m
ad
e
b
y
m
ed
ical
p
er
s
o
n
n
e
l
i
n
h
elp
i
n
g
th
e
h
a
n
d
lin
g
o
f
C
OVI
D
-
1
9
p
atien
ts
,
s
u
c
h
as
ex
p
er
ien
c
i
n
g
f
ac
ial
w
o
u
n
d
s
d
u
e
to
u
s
in
g
N9
5
m
as
k
s
f
o
r
to
o
l
o
n
g
,
u
s
i
n
g
d
iap
er
s
w
h
ile
w
o
r
k
in
g
,
n
o
t e
at
in
g
a
n
d
d
r
in
k
i
n
g
to
s
av
e
p
er
s
o
n
al
p
r
o
tectiv
e
eq
u
ip
m
en
t,
e
v
en
a
m
o
n
g
h
ea
lt
h
w
o
r
k
er
s
w
h
o
cu
t
th
eir
h
air
in
o
r
d
er
to
r
ed
u
ce
th
e
r
is
k
o
f
co
n
tr
ac
t
in
g
it.
I
n
th
e
ab
s
e
n
ce
o
f
p
er
s
o
n
a
l
p
r
o
tectiv
e
eq
u
ip
m
e
n
t,
t
h
e
n
u
m
b
er
o
f
ta
s
k
s
t
h
at
m
u
s
t
b
e
co
m
p
leted
,
f
ac
in
g
v
a
r
io
u
s
p
atien
t
c
h
ar
ac
ter
is
t
ics,
i
s
o
latio
n
,
etc.
,
th
e
y
ar
e
s
ti
ll
r
eq
u
ir
ed
to
p
er
f
o
r
m
h
ig
h
w
o
r
k
p
er
f
o
r
m
an
ce
.
T
h
e
u
n
i
v
ar
iate
an
al
y
s
is
s
h
o
ws
th
at
t
h
er
e
ar
e
d
if
f
er
e
n
ce
s
i
n
m
ed
i
ca
l
p
er
s
o
n
n
e
l
an
x
iet
y
i
n
ter
m
s
o
f
g
en
d
er
,
i
n
w
h
ich
w
o
m
e
n
e
x
p
er
ien
ce
h
ig
h
er
an
x
iet
y
t
h
a
n
m
en
;
t
h
ese
f
i
n
d
in
g
s
s
u
p
p
o
r
t
p
r
e
v
io
u
s
r
esear
ch
[
4
1
,
4
2
]
.
Fem
ale
co
n
s
i
s
te
n
tl
y
h
as
a
h
ig
h
er
p
r
ev
alen
ce
o
f
an
x
iet
y
d
i
s
o
r
d
er
s
,
b
u
t
litt
le
is
k
n
o
wn
ab
o
u
t
h
o
w
g
e
n
d
er
af
f
ec
ts
a
g
e
o
f
o
n
s
et,
ch
r
o
n
ici
t
y
,
co
m
o
r
b
id
it
y
,
an
d
b
u
r
d
en
o
f
illn
e
s
s
[
4
3
]
.
I
n
w
o
m
en
,
g
en
er
alize
d
an
x
ie
t
y
d
is
o
r
d
er
(
GA
D)
h
as
a
p
o
s
itiv
e
co
r
r
elatio
n
w
it
h
d
ep
r
ess
io
n
s
y
m
p
to
m
s
a
n
d
lo
n
eli
n
es
s
,
wh
ile
i
n
m
e
n
it
h
as
co
r
r
elatio
n
w
it
h
s
o
m
atic
s
y
m
p
to
m
s
[
4
4
]
.
A
n
x
iet
y
also
d
if
f
er
ed
s
ig
n
if
ican
tl
y
i
n
ter
m
s
o
f
a
g
e.
T
h
e
p
ar
ticip
an
ts
w
h
o
f
illed
o
u
t
th
is
q
u
esti
o
n
n
a
ir
e
co
n
s
is
ted
o
f
s
ev
er
al
a
g
e
g
r
o
u
p
s
.
Star
ti
n
g
f
r
o
m
t
h
o
s
e
w
h
o
h
av
e
j
u
s
t
e
n
ter
ed
th
e
w
o
r
ld
o
f
w
o
r
k
to
en
ter
r
et
ir
e
m
en
t.
T
h
ese
f
in
d
i
n
g
s
i
n
d
ic
ate
th
at
an
x
iet
y
i
s
h
ig
h
es
t
i
n
t
h
e
21
-
25
ag
e
g
r
o
u
p
,
f
o
llo
w
ed
b
y
t
h
e
2
6
-
3
5
,
3
6
-
4
5
an
d
4
6
-
5
5
ag
e
g
r
o
u
p
s
.
Se
v
e
r
al
s
tu
d
ie
s
h
a
v
e
s
h
o
w
n
t
h
at
y
o
u
n
g
er
in
d
i
v
id
u
a
ls
s
h
o
w
s
y
m
p
to
m
s
o
f
an
x
iet
y
th
an
o
ld
er
p
eo
p
le
[
1
8
,
4
1
,
4
5
]
;
s
u
p
p
o
r
ted
b
y
th
e
f
i
n
d
in
g
t
h
at
o
ld
er
p
e
r
s
o
n
h
as
a
lo
w
er
cu
r
r
en
t a
n
d
li
f
eti
m
e
s
o
c
i
al
an
x
ie
t
y
d
is
o
r
d
er
[
4
6
]
.
I
n
ter
m
s
o
f
th
e
t
y
p
e
o
f
m
ed
ical
p
er
s
o
n
n
el
(
d
o
cto
r
s
,
n
u
r
s
e
s
an
d
o
t
h
er
m
ed
ical
p
er
s
o
n
n
el)
,
n
u
r
s
e
s
o
b
tain
ed
a
h
ig
h
er
a
n
x
ie
t
y
s
co
r
e
th
an
d
o
cto
r
s
an
d
o
th
er
m
ed
ical
p
er
s
o
n
n
el;
r
elev
a
n
t
to
p
r
ev
io
u
s
r
esear
ch
[
4
7
]
.
A
s
t
u
d
y
s
h
o
w
s
t
h
er
e
is
a
d
if
f
er
en
ce
in
an
x
iet
y
b
et
w
ee
n
m
ed
ical
s
taf
f
an
d
o
th
er
m
ed
ical
w
o
r
k
er
s
[
4
8
]
.
T
h
e
s
a
m
e
r
es
u
lt
w
as
r
ev
ea
led
th
r
o
u
g
h
a
s
t
u
d
y
t
h
at
co
m
p
ar
ed
t
o
d
o
cto
r
s
,
n
u
r
s
es
w
er
e
u
n
d
er
h
i
g
h
er
p
r
ess
u
r
e
in
h
an
d
li
n
g
C
OVI
D
-
1
9
[
4
9
]
.
I
n
th
is
s
t
u
d
y
,
o
n
l
y
t
h
e
ch
ar
ac
te
r
is
tics
o
f
t
h
e
len
g
t
h
o
f
w
o
r
k
ex
p
er
ien
ce
d
id
n
o
t
d
eter
m
in
e
t
h
e
d
i
f
f
er
e
n
ce
s
i
n
a
n
x
ie
t
y
a
m
o
n
g
p
ar
ticip
an
t
s
;
t
h
ese
f
i
n
d
in
g
s
s
u
p
p
o
r
t
o
th
er
s
tu
d
ies
[
5
0
]
.
Ho
w
e
v
er
,
th
e
s
co
r
es
f
o
r
m
ed
ical
p
er
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4.
CO
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Me
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F
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C
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19
co
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m
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s
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es.
RE
F
E
R
E
NC
E
S
[1
]
D.
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u
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u
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[2
]
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.
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iss
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J.
L
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“
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ID
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[4
]
C.
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o
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ra
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i
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a
l.
,
“
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[5
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Dja
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[6
]
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Ra
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A
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J.
Jb
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.
Az
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[8
]
D.
W
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k
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Ba
n
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,
“
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re
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Ne
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213
[9
]
T
.
L
.
Ba
rre
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a
,
P
.
J.
No
rto
n
,
“
Qu
a
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ty
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[1
0
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R.
C.
Da
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re
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lan
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,
R.
M
.
Ca
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n
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y
,
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ter
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[1
1
]
C.
C.
Be
ll
,
“
DSM
-
I
V
:
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sti
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AM
A,
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2
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.
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o
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,
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T
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3
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“
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4
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.
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[1
5
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C.
H.
L
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E.
Z
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.
T
.
F
.
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6
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R.
Ch
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P
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tern
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7
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N.
W
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S
.
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8
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J.
A
.
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A
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Risc
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in
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Ep
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CO
VID
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Am
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ric
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T
ro
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e
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9
]
D.
Na
sru
ll
a
h
,
e
t
a
l.
,
“
T
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e
P
sy
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lo
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Im
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a
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Am
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He
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W
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In
Eff
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F
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n
In
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1
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2
]
P
.
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a
len
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la,
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De
lg
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o
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3
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.
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.
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.
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rlo
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,
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4
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.
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lam
i,
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u
n
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ro
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.
[2
5
]
L
.
M
a
,
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.
L
i,
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T
h
e
Re
latio
n
sh
ip
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tw
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tt
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M
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.
[2
6
]
R.
P
ra
d
h
a
n
,
L
.
Je
n
a
,
“
E
m
p
lo
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P
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rf
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e
a
t
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lac
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:
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V
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ti
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n
,
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s
.
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Res
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.
[2
7
]
L
.
Ko
o
p
m
a
n
s,
C.
Be
rn
a
a
rd
s,
V
.
Hild
e
b
ra
n
d
t
.
,
e
t
a
l.
,
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c
t
V
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li
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it
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In
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Qu
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stio
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o
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rn
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l
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.
[2
8
]
J.
P
.
Ca
m
p
b
e
ll
,
“
M
o
d
e
li
n
g
th
e
p
e
rf
o
r
m
a
n
c
e
p
re
d
ictio
n
p
r
o
b
lem
in
in
d
u
strial
a
n
d
o
rg
a
n
iza
ti
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n
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l
p
sy
c
h
o
lo
g
y
.
,
”
Ha
n
d
b
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o
k
o
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stria
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n
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rg
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.
1
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e
d
.
,
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l
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t
o
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CA,
U
S
:
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s
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lt
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Psy
c
h
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ss
,
p
p
.
6
8
7
-
7
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2
,
1
9
9
0
.
[2
9
]
W
.
C.
Bo
r
m
a
n
,
S.
,
M
o
t
o
w
il
d
o
,
“
Ex
p
a
n
d
i
n
g
th
e
Crit
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n
Do
m
a
in
to
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lu
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tex
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rf
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e
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so
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in
Or
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n
s,
N
.
S
c
h
mi
tt
a
n
d
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.
C.
B
o
rm
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n
,
E
d
s.
1
9
9
3
,
p
p
.
7
1
-
9
8
.
[3
0
]
M
.
Ro
t
u
n
d
o
,
P
.
R
.
S
a
c
k
e
tt
,
“
T
h
e
re
lativ
e
i
m
p
o
rtan
c
e
o
f
tas
k
,
c
it
ize
n
sh
ip
,
a
n
d
c
o
u
n
terp
ro
d
u
c
ti
v
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p
e
rf
o
r
m
a
n
c
e
to
g
lo
b
a
l
ra
ti
n
g
s
o
f
jo
b
p
e
rf
o
rm
a
n
c
e
:
A
p
o
li
c
y
-
c
a
p
tu
rin
g
a
p
p
r
o
a
c
h
.
,
”
J
o
u
rn
a
l
o
f
Ap
p
li
e
d
Psy
c
h
o
lo
g
y
,
v
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l.
8
7
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o
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1
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p
p
.
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-
9
0
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1
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6
6
.
[3
1
]
R.
L
.
S
p
i
tze
r,
e
t
a
l.
,
“
A
Brief
M
e
a
su
re
f
o
r
A
ss
e
ss
in
g
G
e
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e
ra
li
z
e
d
A
n
x
iet
y
Diso
rd
e
r:
T
h
e
GA
D
-
7
,
”
J
AM
A
In
ter
n
a
l
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e
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l.
1
6
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.
[3
2
]
A
.
Bu
d
ik
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y
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n
ti
,
A
.
Lara
s
a
ri,
K.
M
a
li
k
.
,
e
t
a
l.
,
“
S
c
re
e
n
in
g
o
f
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e
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d
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Diso
rd
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n
P
a
ti
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ts
w
it
h
Ep
il
e
p
sy
:
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in
g
a
V
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li
d
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n
d
Re
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o
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7
(GA
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,
”
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ro
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y
Res
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rc
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In
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l
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1
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.
[3
3
]
L
.
Ko
o
p
m
a
n
s,
e
t
a
l.
,
“
De
v
e
lo
p
m
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n
t
o
f
a
n
In
d
iv
id
u
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l
W
o
rk
P
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rf
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r
m
a
n
c
e
Qu
e
stio
n
n
a
ire,”
In
t
e
rn
a
ti
o
n
a
l
J
o
u
rn
a
l
Pro
d
u
c
t
ivity
Per
fo
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M
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me
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ts
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2
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5
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.
[3
4
]
L
.
Ko
o
p
m
a
n
s,
"
In
d
iv
id
u
a
l
w
o
rk
p
e
rf
o
r
m
a
n
c
e
q
u
e
stio
n
n
a
ire:
I
n
stru
c
ti
o
n
m
a
n
u
al
,
"
VU
Un
iv.
M
e
d
ica
l
Ce
n
ter
,
2
0
1
5
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Evaluation Warning : The document was created with Spire.PDF for Python.
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14
214
[3
5
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V
.
A
.
Ca
n
a
d
y
,
“
A
P
A
p
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ll
f
in
d
s
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e
a
rl
y
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lf
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s ab
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in
g
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ID‐1
9
,
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M
e
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ly.,
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[3
6
]
M
.
B.
P
e
tzo
l
d
e
t
a
l
.
,
“
Risk
,
re
s
il
ien
c
e
,
p
sy
c
h
o
lo
g
ica
l
d
istres
s,
a
n
d
a
n
x
iety
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t
th
e
b
e
g
in
n
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n
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o
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th
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ID
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p
a
n
d
e
m
ic i
n
G
e
r
m
a
n
y
,
”
Bra
in
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v
.
,
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l
.
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.
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:
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rb
3
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.
[
3
7
]
W
H
O
,
“
M
e
n
t
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l
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e
a
l
t
h
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n
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s
y
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h
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o
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e
r
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t
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o
n
s
d
u
r
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g
C
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V
I
D
-
1
9
O
u
t
b
r
e
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k
,
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r
l
d
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e
a
l
.
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r
g
a
n
.
,
p
p
.
1
-
6
,
2
0
2
0
.
[3
8
]
S.
K
o
r
k
m
a
z
,
A
.
Ka
z
g
a
n
,
S
.
Çe
k
iç
.
,
e
t
a
l.
,
“
T
h
e
a
n
x
iet
y
le
v
e
ls,
q
u
a
li
ty
o
f
sle
e
p
a
n
d
li
f
e
a
n
d
p
ro
b
lem
-
s
o
lv
in
g
sk
il
ls
i
n
h
e
a
lt
h
c
a
re
w
o
rk
e
rs
e
m
p
lo
y
e
d
in
COV
ID
-
1
9
se
rv
ice
s,”
J
o
u
rn
a
l
o
f
Cli
n
ic
a
l
Ne
u
ro
sc
ien
c
e
,
v
o
l.
8
0
,
p
p
.
1
3
1
-
1
3
6
,
2
0
2
0
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o
i:
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tt
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s:/
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.
jo
c
n
.
2
0
2
0
.
0
7
.
0
7
3
.
[3
9
]
T
h
e
G
u
a
rd
ian
a
n
d
Ka
ise
r
He
a
lt
h
Ne
ws
,
“
Co
v
id
-
1
9
h
e
a
lt
h
c
a
re
w
o
rk
e
r
d
e
a
th
to
ll
:
8
2
1
d
e
a
th
s
u
n
d
e
r
in
v
e
stig
a
ti
o
n
,
”
T
h
e
Gu
a
rd
i
a
n
,
2
0
2
0
.
[4
0
]
B.
A
la
m
,
“
IDI:
6
8
Do
k
ter M
e
n
i
n
g
g
a
l
Du
n
ia k
a
re
n
a
Co
v
id
-
1
9
,
”
L
i
p
u
ta
n
6
,
2
0
2
0
.
[4
1
]
Y.
Hu
a
n
g
a
n
d
N.
Zh
a
o
,
“
G
e
n
e
ra
l
ize
d
a
n
x
iet
y
d
iso
rd
e
r,
d
e
p
re
ss
iv
e
s
y
m
p
to
m
s
a
n
d
sle
e
p
q
u
a
li
ty
d
u
r
in
g
COV
ID
-
19
o
u
t
b
re
a
k
in
Ch
in
a
:
a
w
e
b
-
b
a
se
d
c
ro
ss
-
se
c
ti
o
n
a
l
su
rv
e
y
,
”
Psy
c
h
i
a
try
Res
e
a
rc
h
,
v
o
l.
2
8
8
,
p
p
.
1
1
2
9
5
4
,
2
0
2
0
,
d
o
i
:
h
tt
p
s:/
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rg
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0
.
1
0
1
6
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.
p
sy
c
h
re
s.2
0
2
0
.
1
1
2
9
5
4
.
[4
2
]
D
.
Hu
,
e
t
a
l.
,
“
F
ro
n
tl
in
e
n
u
rse
s’
b
u
r
n
o
u
t,
a
n
x
iety
,
d
e
p
re
ss
io
n
,
a
n
d
f
e
a
r
sta
tu
se
s
a
n
d
th
e
ir
a
ss
o
c
iate
d
f
a
c
to
rs
d
u
rin
g
th
e
COV
ID
-
1
9
o
u
tb
re
a
k
in
W
u
h
a
n
,
Ch
i
n
a
:
A
larg
e
-
sc
a
le
c
ro
ss
-
se
c
ti
o
n
a
l
st
u
d
y
,
”
T
h
e
L
a
n
c
e
t
,
v
o
l.
2
4
,
p
.
1
0
0
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2
4
,
2
0
2
0
,
d
o
i:
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tt
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s:/
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0
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1
0
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.
e
c
li
n
m
.
2
0
2
0
.
1
0
0
4
2
4
.
[4
3
]
N.
C.
Do
n
n
e
r
,
C.
A
.
L
o
w
r
y
,
“
S
e
x
d
iff
e
re
n
c
e
s
in
a
n
x
iet
y
a
n
d
e
m
o
ti
o
n
a
l
b
e
h
a
v
io
r,
”
Pf
lü
g
e
rs
Arc
h
.
-
Eu
r.
J
.
Ph
y
sio
l.
,
v
o
l.
4
6
5
,
n
o
.
5
,
p
p
.
6
0
1
-
6
2
6
,
2
0
1
3
,
d
o
i:
1
0
.
1
0
0
7
/s
0
0
4
2
4
-
0
1
3
-
1
2
7
1
-
7.
[4
4
]
F
.
H.
Bo
e
h
le
n
,
e
t
a
l.
,
“
G
e
n
d
e
r
-
sp
e
c
if
i
c
p
re
d
icto
rs
o
f
g
e
n
e
ra
li
z
e
d
a
n
x
iety
d
iso
rd
e
r
sy
m
p
to
m
s
in
o
ld
e
r
a
d
u
l
ts:
Re
su
lt
s
o
f
a
larg
e
p
o
p
u
lati
o
n
-
b
a
se
d
stu
d
y
,
”
J
o
u
rn
a
l
Af
fec
t
ive
Diso
rd
er
,
vo
l.
2
6
2
,
p
p
.
1
7
4
-
1
8
1
,
2
0
2
0
.
[4
5
]
G
.
A
.
Bre
n
e
s,
e
t
a
l.
,
“
A
g
e
a
n
d
ra
c
ial
d
if
f
e
r
e
n
c
e
s
in
th
e
p
re
se
n
tatio
n
a
n
d
trea
tm
e
n
t
o
f
g
e
n
e
r
a
li
z
e
d
a
n
x
iety
d
iso
rd
e
r
in
p
rim
a
r
y
c
a
re
,
”
J
o
u
rn
a
l
A
n
x
iety
Diso
rd
er
,
v
o
l.
2
2
,
n
o
.
7
,
p
p
.
1
1
2
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-
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1
3
6
,
2
0
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8
,
d
o
i:
1
0
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1
0
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6
/
j.
jan
x
d
is.
2
0
0
7
.
1
1
.
0
1
1
.
[4
6
]
A
.
J.
F
li
n
t
,
e
t
a
l.
,
“
E
f
fe
c
t
o
f
a
g
e
o
n
th
e
f
re
q
u
e
n
c
y
o
f
a
n
x
iet
y
d
iso
rd
e
rs i
n
m
a
jo
r
d
e
p
r
e
ss
io
n
w
it
h
p
s
y
c
h
o
ti
c
f
e
a
tu
re
s
,
”
Am
e
ric
a
n
J
o
u
rn
a
l
Ge
ria
tr
ic
p
sy
c
h
ia
try
Off
ici
a
l
J
o
u
rn
a
l
Am
Ame
ric
a
n
Asso
c
i
a
ti
o
n
Ge
ria
tr
ic
Psy
c
h
ia
try
,
v
o
l
.
1
8
,
n
o
.
5
,
p
p
.
4
0
4
-
4
1
2
,
M
a
y
2
0
1
0
.
[4
7
]
Z.
Z
h
u
,
e
t
a
l.
,
“
COV
ID
-
1
9
in
W
u
h
a
n
:
S
o
c
io
d
e
m
o
g
ra
p
h
ic
c
h
a
ra
c
t
e
risti
c
s
a
n
d
h
o
s
p
it
a
l
s
u
p
p
o
rt
m
e
a
su
re
s
a
ss
o
c
iate
d
w
it
h
th
e
i
m
m
e
d
iate
p
s
y
c
h
o
lo
g
ica
l
i
m
p
a
c
t
o
n
h
e
a
lt
h
c
a
re
w
o
rk
e
r
s
,
”
T
h
e
L
a
n
c
e
t
,
v
o
l.
2
4
,
p
.
1
0
0
4
4
3
,
2
0
2
0
,
d
o
i
:
h
tt
p
s:/
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o
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rg
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0
.
1
0
1
6
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.
e
c
li
n
m
.
2
0
2
0
.
1
0
0
4
4
3
.
[4
8
]
Q.
Ca
i
,
e
t
a
l.
,
“
T
h
e
m
e
n
tal
h
e
a
lt
h
o
f
f
ro
n
tl
i
n
e
a
n
d
n
o
n
-
f
ro
n
tl
in
e
m
e
d
ica
l
w
o
rk
e
rs
d
u
rin
g
t
h
e
c
o
ro
n
a
v
iru
s
d
ise
a
se
2
0
1
9
(COV
ID
-
1
9
)
o
u
tb
re
a
k
in
Ch
in
a
:
A
c
a
se
-
c
o
n
tro
l
stu
d
y
,
”
J
o
u
rn
a
l
Af
fec
t
ive
Diso
rd
er
,
v
o
l.
2
7
5
,
p
p
.
2
1
0
-
2
1
5
,
2
0
2
0
,
d
o
i:
h
tt
p
s:/
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o
i.
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rg
/1
0
.
1
0
1
6
/j
.
jad
.
2
0
2
0
.
0
6
.
0
3
1
.
[4
9
]
H.
W
a
n
g
,
e
t
a
l.
,
“
He
a
lt
h
c
a
re
wo
rk
e
rs’
stre
ss
w
h
e
n
c
a
rin
g
f
o
r
COV
ID
-
1
9
p
a
ti
e
n
ts:
A
n
a
lt
ru
isti
c
p
e
rsp
e
c
ti
v
e
,
”
Nu
rs
in
g
Et
h
ics
,
v
o
l.
27
,
n
o
.
7
,
p
p
.
1
4
9
0
-
1
5
0
0
,
2
0
2
0
,
d
o
i
:
1
0
.
1
1
7
7
/
0
9
6
9
7
3
3
0
2
0
9
3
4
1
4
6
.
[5
0
]
J
.
L
a
i
,
e
t
a
l
.
,
“
F
a
c
t
o
r
s A
ss
o
c
i
a
te
d
W
i
t
h
M
e
n
t
a
l
H
e
a
l
t
h
O
u
t
c
o
m
e
s
A
m
o
n
g
H
e
a
l
t
h
C
a
r
e
W
o
rk
e
r
s
E
x
p
o
se
d
t
o
C
o
r
o
n
a
v
i
r
u
s
D
i
s
e
a
s
e
2
0
1
9
,
”
J
A
M
A
Ne
t
w
.
o
p
e
n
,
v
o
l
.
3
,
n
o
.
3
,
p
p
.
1
-
12,
2
0
2
0
,
d
o
i
:
1
0
.
1
0
0
1
/
j
a
m
a
n
e
tw
o
r
k
o
p
e
n
.
2
0
2
0
.
3
9
7
6
.
[5
1
]
S
.
G
u
p
ta
,
e
t
a
l.
,
“
P
sy
c
h
o
lo
g
ica
l
He
a
lt
h
Am
o
n
g
A
r
m
e
d
F
o
rc
e
s
D
o
c
to
rs
D
u
rin
g
CO
V
ID
-
1
9
P
a
n
d
e
m
ic
in
In
d
ia,”
In
d
i
a
n
J
o
u
rn
a
l
o
f
P
s
y
c
h
o
l
o
g
i
c
a
l
M
e
d
icin
e
,
v
o
l.
4
2
,
n
o
.
4
,
p
p
.
3
7
4
-
3
7
8
,
2
0
2
0
,
d
o
i:
1
0
.
1
1
7
7
/
0
2
5
3
7
1
7
6
2
0
9
3
4
0
3
7
.
[5
2
]
S
.
F
o
x
,
P
.
E
.
S
p
e
c
to
r
,
D.
M
il
e
s,
“
Co
u
n
terp
r
o
d
u
c
ti
v
e
w
o
rk
b
e
h
a
v
io
r
(CW
B)
in
re
sp
o
n
se
to
jo
b
stre
ss
o
rs
a
n
d
o
rg
a
n
iza
ti
o
n
a
l
j
u
stice
:
so
m
e
m
e
d
iato
r
a
n
d
m
o
d
e
ra
to
r
tes
ts
f
o
r
a
u
to
n
o
m
y
a
n
d
e
m
o
ti
o
n
s,”
J
o
u
rn
a
l
V
o
c
a
t
i
o
n
a
l
Beh
a
v
io
r
,
v
o
l.
5
9
,
n
o
.
3
,
p
p
.
2
9
1
-
3
0
9
,
2
0
0
1
,
d
o
i:
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tt
p
s:/
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o
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rg
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0
.
1
0
0
6
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v
b
e
.
2
0
0
1
.
1
8
0
3
.
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